Persistent abnormalities in red cell parameters following treatment of lymphoma

D. Meytes, D. Leshno, M. Berkowicz, M. Modant, B. Ramot

Research output: Contribution to journalArticlepeer-review

Abstract

Patients who have recovered from malignant lymphoma are at an increased risk of secondary acute leukemia (AL), and overt AL is frequently preceded by a myelodysplastic syndrome. Although the statistical risk is significant, only a minority of the patients will be so affected. We have reviewed peripheral blood counts of patients with Hodgkin's disease (HD) and non-Hodgkin's lymphoma (NHL) treated in the Departments of Hematology at the Edith Wolfson and Chaim Sheba Medical Centers, Israel. Included were only those who went into a complete remission and remained lymphoma free for extended periods. There were 85 patients with HD and 36 with NHL. In both groups peripheral blood counts at diagnosis were within the normal range. A prolonged follow-up (<4 y), during which no further treatment was given, revealed a sustained increment over time of MCV (MČV) both in HD and NHL. A persistent monocytosis in HD patients was also evident. MČV was larger in HD. The difference at the end of the follow-up period was as follows: 10.1 fl + 11.8 in HD vs 5.0 fl + 6.2 in NHL, (P > 0.001). In addition, a significant loss of the normal correlation between the MCV and levels of hemoglobin was seen at the last follow-up. The change in MCV was present in all treatment groups, its magnitude increasing from radiotherapy to chemotherapy to combined radio chemotherapy. This trend is in analogy to the risk of secondary AL which is lower in NHL vs HD. Furthermore, it is lowest post radiotherapy and highest when both treatment modalities are used. In conclusion, the data demonstrate that a form of a prolonged subclinical effect on erythropoiesis is rather a common side effect of lymphoma treatment. There is a striking analogy between the acquired abnormality as seen here and other variables known to be associated with the subsequent risk of secondary AL. These results indicate that the treatment of lymphoma commonly induces bone marrow aberrations which are prolonged and of a wider spectrum than hitherto appreciated.

Original languageEnglish
Pages (from-to)341-345
Number of pages5
JournalLeukemia and Lymphoma
Volume15
Issue number3-4
DOIs
StatePublished - 1994

Keywords

  • Lymphoma treatment
  • Red cell volume (MCV)
  • Secondary leukemia

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